Gastric cancer in Africa: Current management and outcomes

Table 1 Gastric cancer incidence and mortality rates

	Incidence1			Mortality1
	Males	Females	Both	Males	Females	Both
Africa2	4.7	3.3	4.0	4.4	3.2	3.8
Northern	3.9	2.4	3.2	3.7	2.3	3.0
Eastern	5.6	4.0	4.7	5.4	3.8	4.6
Central	5.3	4.7	4.0	5.2	4.6	4.8
Southern	4.1	2.2	3.0	3.9	1.8	2.8
Western	4.5	3.3	3.8	4.3	3.1	3.7
Asia	25.9	11.7	18.5	18.3	8.9	13.4
North America	5.8	2.8	4.2	2.8	1.8	2.1
South America	17.3	8.4	12.4	14.2	6.9	10.2
Europe	14.5	7.0	10.3	11.3	5.3	7.9
Australia	7.4	3.4	5.3	4.3	2.1	3.1

¹Incidence and mortality are represented as age-standardized rates (per 100000);

²Countries within each geographic region (per GLOBOCAN) is listed below: Africa: Northern: Algeria, Egypt, Libya, Morocco, Sudan, Tunisia, Western Sahara; Eastern: Burundi, Comoros, Djibouti, Eritrea, La Reunion-France, Kenya, Madagascar, Malawi, Mauritius, Mozambique, Rwanda, Somalia, Tanzania, Uganda, Zambia, Zimbabwe; Central: Angola, Cameroon, Central African Republic, Change, Democratic Republic of Congo, Republic of Congo, Equatorial Guinea, Gabon; Southern: Botswana, Lesotho, Namibia, South African Republic, Swaziland; Western: Benin, Burkina Faso, Cape Verde, Cote d’Ivoire, the Gambia, Ghana, Guinea-Bissau, Guinea, Liberia, Mali, Mauritania, Niger, Nigeria, Senegal, Sierra Leone, Togo; Asia: Eastern: China, Japan, South Korea, Mongolia, Taiwan; South-Eastern: Brunei Darussalam, Cambodia, Indonesia, Lao, Malaysia, Myanmar, Philippines, Singapore, Thailand, Timore-Leste, Vietnam; South-Central: Afghanistan, Bangladesh, Bhutan, India, Iran, Kazakhstan, Kyrgyzstan, Maldives, Nepal, Pakistan, Sri Lanka, Tajikistan, Turkmenistan, Uzbekistan; Western: Armenia, Azerbaijan, Bahrain, Gaza Strip and West Bank (Palestine), Iraq, Israel, Jordan, Kuwait, Lebanon, Oman, Qatar, Saudi Arabia, Syria, Turkey, United Arab Emirates, Yemen;North America: United States, Canada; South America: Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, French Guyana, Guyana, Paraguay, Peru, Suriname, Uruguay, Venezuela; Europe: Central and Eastern: Belarus, Bulgaria, Czech Republic, Hungary, Republic of Moldova, Poland, Romania, Russia, Slovakia, Ukraine; Northern: Denmark, Estonia, Finland, Iceland, Ireland, Latvia, Lithuania, Norway, Sweden, United Kingdom; Southern: Albania, Bosnia, Croatia, Cyprus, Greece, Italy, Former Yugoslav Republic of Macedonia, Malta, Montenegro, Portugal, Serbia, Slovenia, Spain; Western: Austria, Belgium, France, Germany, Luxembourg, The Netherlands, Switzerland.

Table 2 Treatment and survival outcome

Country	Year of publication and study design	Author	Sample size	Overall survival	Treatment	Post-operative complication	Post-operative mortality	Incidence and Mortality rate per Globocan
Tanzania	2012, retrospective review	Mabula et al[15]	232	5 yr survival: 32.8%	Surgery: 223/232 (96.1%)	37.1%	18.1%	2/100000
					Chemotherapy: 56 (24%)			2/100000
					Radiotherapy: 12 (5.1%)
Mali (Abstract, French article)	2012	Dembeleet al[17]	425	1 yr survival: 15.5%	200 (65%): surgery	-	-	20.3/100000
					105 (34.3%) : no surgery			19.7/100000
					4 (1.3%): chemotherapy
Nigeria	2011, retrospective review	Ahmed et al[16]	179	13.6 mo	Surgery: 155 (86.6%)	43 (27.7%)	25 (16.1%)	2.2/100000
				1 yr post gastrectomy: 70.1%				2.1/100000
				5 yr post gastrectomy: 21.8%
Zimbabwe	2011	Chokunonga et al[18]	-	5 yr survival: 20%	-	-	-	5.3/100000
								5/100000
Nigeria	2010, retrospective	Osime et al[19]	-	mortality rate 39.1; 66% died within one year of diagnosis	30.4% presented within in year			2.2/100000
								2.1/100000
Tunisia (Abstract, French article)	2006, retrospective	Arfaouiet al[24]	140	26.5 mo, 13 mo and 5 mo after curative resection, palliative resection and without resection	Curative and palliative resection
Tunisia (Abstract, French article)	2004	Ayite et al[23]	63	3 mo: 21%				4.2/10000000
				1 yr survival: 7%				3.9/100000
Senegal (Abstract, French article)	2003	Fall et al[20]	60	Total overall survival : 20%	-	-	-	6.1/100000 5.9/100000
Uganda	2001, prospective, descriptive	Ibingira[21]	35	1 yr survival after partial gastrectomy: 39.1% -	94.5% presented with advanced cancer, and no curative surgery possible			9/100000
								8.7/100000
Ethiopia	2000, prospective	Johnson et al[22]	96		90% presented in advanced stage;	-	18.6%	3.5/100000
					40% had resectable lesions			3.4/100000